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PubMed2006

Gender, work, and HIV risk: determinants of risky sexual behavior among female entertainment workers in China.

We proposed to integrate cognitive and social factors in the study of unprotected commercial sex. Data from 159 female entertainment workers from 15 establishments in Shanghai who reported commercial sex in the month prior to interview were used to test the approach. Two-sample t tests and multivariate logistic regression were conducted to examine if and how individual cognitive and social influence factors affect the odds of consistent condom use. About 21% of participants reported consistent condom use. Both individual cognitive and social influence factors were important correlates of condom use; models containing either alone suffered significantly in explanatory power. Perceived easiness in condom use was the most proximate determinant of condom use. It helped to translate HIV knowledge and prevention motivation into behavior and to mediate the impact of sexual relationship power. Prevention intervention is urgently needed and should focus on self-efficacy training and promoting supportive social and working environments.

Adult↗
PubMed1994

Sexual communication is associated with condom use by sexually active incarcerated adolescents.

PURPOSE: Incarcerated adolescents are at increased risk for infection by sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Moreover, condom use by this population is extremely low. Although interpersonal variables such as sexual communication have been found to be associated with condom use in other populations, few researchers have investigated this relationship among adolescents requiring detention in juvenile facilities. The present study investigated the relationship between communication about sexual history and incarcerated adolescents' condom use. METHODS: We used multivariate logistic regression techniques to analyze interview data from a predominantly Latino sample of 2,132 sexually active adolescents detained in Los Angeles County Juvenile Hall. RESULTS: Despite high numbers of lifetime sexual partners, a substantial majority of respondents (67%) reported that they never used condoms during sexual intercourse. Respondents who communicated with their sex partner(s) about each others' sexual history were significantly more likely to use condoms during sexual intercourse. Adolescents who reported that they knew someone with AIDS were also more likely to use condoms. CONCLUSIONS: Interventions designed to increase condom use among sexually active incarcerated adolescents should include a component addressing sexual communication practices. More research is needed on the ways in which adolescents learn to communicate about sex.

Adolescent↗
PubMed1994

Young adults, alcohol and condom use: what is the connection?

PURPOSE: Concern about HIV in adolescents and young adults has led a number of investigators to examine the link between drinking and risky behavior, including failure to use condoms. Most of the studies that conclude that this link exists have used global measures of both variables and have not investigated drinking and use of condoms on the same occasion. If drinking leads to low condom use, both behaviors must occur together and the failure to find that they do weakens the hypothesis that they are causally related. METHODS: Data from three separate studies on different adolescent and young adult populations are reported. In each study the relationship between drinking behavior and condom use at last intercourse was examined. RESULTS: Drinking was not related to lower condom use in any of the populations studied. CONCLUSIONS: This negative result implies that the dis-inhibiting effect of alcohol is not a major factor in the failure of young adults to use condoms.

Adolescent↗
PubMed1999

Adolescent sexuality and sexually transmitted diseases: attitudes, beliefs, knowledge, and values.

This study described rural adolescents' attitudes, beliefs, knowledge, and values with regard to sexuality and sexually transmitted diseases (STDs). Rotter's Social Learning Theory (1954) provided the theoretical framework for this descriptive, correlational design. The convenience sample consisted of 170 students from one rural high school. Consistent with past studies, results included the following: participants had more correct than incorrect knowledge related to sexual intercourse and STDs; the majority had positive attitudes toward condom use and believed it was OK for peers to have sex with a "steady;" the value of an exciting life correlated positively with attitudes toward sex; knowledge of sexual intercourse correlated positively with attitudes toward condom use; and the value health correlated positively with knowledge of sex and attitudes toward condom use, and negatively with attitudes toward sex. The findings in this study suggest the need for ongoing research with adolescents in the area of sexuality and STDs. Additionally, the findings support past studies, which revealed that knowledge of sexual intercourse and STDs has little impact on attitudes toward sexual intercourse. With the serious nature of some of the undesired consequences of adolescent sexual behavior, current and accurate information on this population is needed to assist health educators in developing interventions in this area.

Adolescent↗
PubMed2003

Asthma caused by human seminal plasma allergy.

Human seminal plasma allergy (HSPA) in women is a rare phenomenon and can be life-threatening. Hypersensitivity reactions occur during or immediately after coitus and are usually caused by sensitization to proteins in the seminal fluid. This can be very distressing for the patients and their partners. Young, married female patients with episodic asthma dating to their marriage with a history of difficulty in conceiving were specifically asked for local and systemic symptoms chronologically related to coitus. This methodology was adopted keeping in view our social conditions and sensitive nature of the information sought. Two patients thus detected were evaluated further. Condom usage, on our advice, abolished both local and systemic postcoital symptoms. Both patients tested positive to intradermal skin test with the seminal plasma antigen (SPA) derived from their respective husbands and, in patient 1, was accompanied by intense burning, irritation, and itching of the skin. Specific IgE against SPA was demonstrated in the serum of both patients. Elevated levels of total IgE were also detected. A high index of suspicion is needed to diagnose HSPA, especially the local forms, which can easily be overlooked due to patient embarrassment and lack of physician awareness.

Adult↗
PubMed1997

A process evaluation of condom availability in the Seattle, Washington public schools.

In 1993, Seattle began making condoms available in all of its 15 high schools. As part of an evaluation of this program, 16 focus groups with students from 13 high schools were conducted to explore students' perceptions of the school environment, program effectiveness, and suggestions for program improvement. The study also included data from a student survey conducted in 10 high schools. The focus group results revealed that students support school condom availability but have concerns about privacy when obtaining condoms. Students prefer obtaining condoms from baskets in private areas of school-based clinics to obtaining them from vending machines. Students do not believe that having condoms available has affected sexual activity or condom use among students. Recommendations for improving school condom availability include access to free condoms in private locations.

Adolescent↗
PubMedDate not supplied

HIV sexual risk reduction interventions for women: a review.

AIDS has emerged as a serious public health threat for women. Reducing the risk for HIV infection among sexually active women requires the adoption of preventive strategies that effectively inhibit viral transmission. However, there is a paucity of published literature describing interventions targeted toward women and even fewer published reports evaluating their effectiveness. We conducted a search of HIV prevention interventions for women using the MEDLINE, ERIC and PSYCHLIT on-line computer database for the years January 1984-May 1995 to assess the effectiveness of interventions in increasing condom use during sexual intercourse. Interventions efficacious at increasing condom use applied a social psychological model of behavior to guide the development and implementation of the intervention, used randomized controlled designs to evaluate program efficacy, emphasized gender-related influences, were peer-led, and used multiple intervention sessions. While these findings are promising, methodologic limitations preclude any definitive assessment of programmatic efficacy. One challenge for future studies is to corroborate and extend these findings using rigorous methodologic research designs to evaluate programmatic efficacy, in particular, longer follow-up to assess stability of treatment effects over time. Another challenge is to understand the implications of previous research for the development of more gender-relevant interventions. The urgency of the HIV epidemic demands that the development and evaluation of HIV-prevention interventions tailored toward women remain a public health priority. Medical Subject Headings (MeSH): women, HIV/AIDS, interventions, prevention.

Adolescent↗
PubMed1997

Evaluation of the HIV risk reduction intervention for women entering inpatient substance abuse treatment.

OBJECTIVES: Interventions to lower HIV risk behavior among drug users have concentrated on reduction of high risk injection practices. Less attention has been directed to non-injecting drug users and drug-involved women. Female non-injecting drug users (e.g., women who abuse alcohol or crack cocaine) are also at substantial risk for sexual transmission of HIV due to multiple partners, partners who self-inject and share needles, exchange of sex for drugs, coerced sex, high rates of sexually transmitted diseases, and low rates of condom use. This study compared the effectiveness of an educational intervention (EC) against the behavior skills training intervention (BST) in reducing sexual risk behavior among women (N = 117) court-ordered into inpatient drug treatment. METHODS: Participants were assessed at baseline, post intervention, and 2 months after discharge from the drug treatment facility. RESULTS: Women in both conditions reported high rates of sexual risk behavior prior to the intervention. Women in both conditions had more positive attitudes toward HIV prevention and reported greater partner agreement with condom use at the post intervention assessment. However, these changes were not maintained at follow-up for women in the EC condition, whereas women in BST continued to show improvement post discharge. Women in the BST condition showed marked, while women in EC showed little improvement in communication skills and no improvement in condom application skill. At follow-up, women in both conditions had reduced drug use and drug-related high risk sex activities. BST women had increased their condom use while women in EC evidenced a decrease. Condom use increased from 35.7% to 49.5% of vaginal intercourse occasions for BST women and decreased from 28.8% to 15.8% for women in EC. CONCLUSIONS: Results suggest a brief skills training intervention embedded in drug treatment programs can reduce sexual risk for HIV-infection after discharge.

Adult↗
PubMed1993

The condom race.

The condom race is a hands-on activity that can help teach young people condom use as part of safer sex practices. Although it is well documented that students know about condom use, they often do not do what they know they should. One possible explanation for this is that the students may lack the skills and confidence they need to have when they use condoms. The condom race offers students a chance to gain skills and confidence in a humorous, nonthreatening way. During the exercise, which is based on the concept of a relay race, students touch, feel, and practice putting condoms on penis models. After participating in the activity, students reported increased confidence in their ability to use, discuss, and carry condoms. The condom race is a quick, amusing, and easy activity.

Adolescent↗
PubMed1993

Sexual issues and condom use among injecting drug users.

Recent surveys of injecting drug users reveal that their injecting behaviours have changed in the light of HIV, but their sexual behaviours have not and, in particular, they remain reluctant to use condoms to reduce the risks of sexual transmission. In an attempt to explore this issue further the present study assessed the behaviours and attitudes of injecting drug users to sexual issues, including condom use. Condom use was low. Obstacles to their use included for some a desire to conceive, for many a belief in their infertility, a perceived invulnerability to HIV infection through their sexual behaviour patterns, a dislike of condoms and difficulty in negotiating condom use with partners. The lifestyle of drug users may also have an influence on condom use. Many drug users funded their habit through illegal activities including prostitution, theft and fraud. The association between these and other factors and condom use are explored.

Adult↗
PubMed1999

Measuring the impact of a behaviour change intervention for commercial sex workers and their potential clients in Malawi.

A peer-education HIV/AIDS prevention programme for bar-based sex workers and their potential clients (long-distance truck drivers) in Malawi was evaluated for impact. A mixed method approach was used, the tools being structured questionnaires and focus group discussions. The results showed that in the active districts, the presence of sex worker peer educators led to a increase in condom use with paying partners (90.3 compared to 66.7 and 76.3% in the two other groups--non-active and average) and increased condom distribution. Condom use with regular non-paying partners of sex workers had, however, not increased since the baseline data. The truck driver peer educators were found to be generally inactive but companies where training had occurred were more likely to encourage and distribute condoms. The qualitative data gave a more in-depth view of several areas for concern: the reasons for the non-use of condoms with non-paying partners; acceptance of educators by their peers; and the sex workers' and truck drivers' criteria for condom use based neither on knowledge nor on their own risk awareness. These issues need to be explored further.

Condoms↗
PubMedDate not supplied

American women's sexual behavior and exposure to risk of sexually transmitted diseases.

According to nationally representative data from the 1988 National Survey of Family Growth and the 1988 and 1989 General Social Surveys, 67% of all women aged 15-44 who have ever had intercourse have had more than one partner, 41% have had four or more, 23% six or more and 8% more than 10; 71% have had one or more nonmarital partners. Fewer than 1% of currently married women report having had more than one partner in the previous three months, compared with 13% of formerly married women and 9% of single women who are sexually active. For the most part, women with multiple partners do not have characteristics that set them apart from other women; women in all age-groups and racial or ethnic groups appear equally likely to have multiple partners while unmarried. Fifty-seven percent of women who report multiple partners have never been married, and another one-quarter are currently divorced. Twenty-one percent are teenagers, 46% are aged 20-29 and 24% are in their 30s. Between 27% and 39% of all sexually active women aged 18-44 are estimated to have had direct or indirect contact with more than one sexual partner during the preceding 12 months (including women with only one partner whose partner had multiple partners). About 20% of currently sexually active women reported using the condom, but one in five condom users had not used one at last intercourse. Once social and demographic factors are controlled, condom users with multiple partners are less likely than other condom users to have used a condom at last intercourse.

Adolescent↗
PubMed1996

Developmental sophistication among adolescents of negotiation strategies for condom use.

Condoms are an important method of reducing the risk of sexually transmitted disease among sexually active adolescents. This study used a developmental approach to examine the negotiation of condom use. The Interpersonal Negotiation Strategy Interview was administered to adolescents using two vignettes that were focused on the negotiation of "safer sex" behaviors. The sample consisted of 196 girls and 92 boys recruited from their primary care clinic or Job Corps. The mean scores for each problem-solving step were at the subjective, unilateral stage, which indicates that problems are resolved through one-way methods. Current educational strategies and the lack of mutuality in adolescents' sexual relationships influence the level of negotiation skills. Interventions need to be at the appropriate developmental level but also need to encourage progress toward collaborative relationships.

Adolescent↗
PubMedDate not supplied

Increased condom use among teenage males, 1988-1995: the role of attitudes.

CONTEXT: Understanding whether and to what degree changes in young men's attitudes explain increases in condom use over time can be useful in developing more effective disease prevention strategies. METHODS: Data from the 1988 and the 1995 National Survey of Adolescent Males are used to determine changes in attitudes toward condoms, pregnancy prevention and HIV and AIDS. Two-limit tobit models are employed to investigate the association between these attitudes and condom-use behavior and to examine how this relationship may have changed over time. RESULTS: Between 1988 and 1995, young men's attitudes toward partner appreciation of condom use, condom-use embarrassment and pleasure reduction from condom use all changed in a direction suggestive of more consistent condom use. However, attitudes related to pregnancy prevention and AIDS avoidance changed in a direction suggestive of less-consistent condom use. Changes over time in the strength of the relationship between three attitude measures (masculinity, pleasure reduction and partner appreciation) and condom use also were predictive of lower levels of condom-use consistency. Only the strength of the relationship between condom-use embarrassment and consistent condom use changed in a direction corresponding to observed increases in rates of condom use among young men. CONCLUSIONS: Many of the significant changes in young males' attitudes toward condoms do not explain the increase in consistent condom use among adolescent males that occurred between 1988 and 1995. However increasing male contraceptive responsibility and emphasizing the risks and consequences of contracting HIV appear to be viable routes for policymakers to explore. Efforts particularly need to be targeted toward Hispanics.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Sexual behaviors and safer sex practices of college students on a commuter campus.

The sexual behaviors and safer sex practices of college students at a midwestern commuter university are described. Responses from a student sample of 1,919 indicated that slightly more than 10% used condoms consistently. The most frequently cited reasons for not using condoms were monogamy (83%) and preferring other forms of birth control (31%). The leading reason for consistent condom use was fear of HIV infection (72%). Approximately 75% indicated they talked with their sexual partners about HIV prevention; women reported communicating significantly more often than men did (p < 0.0001). Seventy percent of the sample reported they had only one sexual partner during the past year. Students who had multiple partners during the past year were more likely to practice such unsafe sexual practices as not using condoms and not communicating about HIV prevention. Unsafe sexual practices occur on nontraditional university campuses just as frequently as they do on more traditional campuses, thus supporting the need for HIV prevention programs on every college and university campus.

Adolescent↗
PubMed1994

Canadian street youth: correlates of sexual risk-taking activity.

The purpose of this study was to develop a national perspective on the sexual activity of street youth in Canada and to determine the correlates of risky sexual behavior according to street youth's link to the street. Five categories of street youth (sex industry workers, heavy drug and/or alcohol users, young offenders, homeless and unemployed) ages 15 to 20 years were recruited in 1988 from 10 Canadian urban centers to participate in a 45-minute structured interview focusing on knowledge and attitudes regarding sexually transmitted diseases (STD)/human immunodeficiency virus, current sexual practices, sexual and STD history, demographic background, alcohol/drug use and relationship with parents and peers. Data from the survey were also compared with findings from more than 15,000 non-street youth adolescents surveyed in the same year with the use of parallel questionnaires. Of 712 street youth surveyed (391 males, mean age 17.3 years; 321 females, mean age 16.8 years), the majority were sexually active (95% males, 93% females) and 22% reported at least one previous STD (16% males, 30% females). The lowest STD rates were in unemployed males (5%) and the highest (68%) in female sex industry workers. STD/human immunodeficiency virus high risk behaviors were frequent with 47% of males and 41% of females having had at least 10 different partners, 73% of males and 75% of females inconsistently using condoms and 22% of males and 24% of females participating in anal intercourse. Even among sex industry workers more than 40% used condoms inconsistently.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗